| NPI | 1093441867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CHAVEZ Owner 562-253-5842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 174400000X Specialist |
| 207PS0010X Emergency Medicine, Sports Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2022-07-25 |